Tuesday Morning With Justin: Healthcare, Leadership & Life

Send us Fan Mail

We break down how a “$0 copay” specialty drug can cost an employer $7,600 per injection and why that gap exists. Then we show how transparent sourcing cut Enbrel from $38,000 a year to about $2,000 without sacrificing care.

• how Enbrel is marketed versus what it treats
• the hidden employer cost behind copay programs
• five fills adding up to roughly $38,000
• plan risk thresholds and why unit cost matters
• sourcing the same medication for $400 per fill
• scaling savings across more specialty drugs
• why healthcare needs real price transparency

Let me know if there's any topic we want to cover in the future

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

We break down why 1% of employees drive a third of healthcare costs and how multi‑million dollar claims are rising. We show how site of care, quality data, and smart incentives can cut spend without cutting outcomes, including a $72k infusion savings case.

• 1% of employees driving a third of spend
• Multi‑million dollar claims rising 8% year over year and 50% over four years
• High‑cost conditions including neoplasms, NICU, cardiovascular, sepsis, leukemia, lymphoma, multiple myeloma
• Inpatient stays as the biggest cost driver
• Traditional cost shifting failing to control trend
• Site of care strategy for specialty drugs and infusions
• Transparent imaging and surgical steerage with $0 options
• Using infection rates and outcomes to build trust
• Designing benefits that guide members to high‑value care

Drop a comment, shoot me a text, let me know your thoughts.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Listener Question: "What do you actually do?" 

Ever wondered what a benefit advisor actually does? It's a question that prompted Justin Futrell to peel back the curtain on his role at True North Companies in this enlightening episode.

While placing health insurance represents the foundation of Justin's work—accounting for roughly 80% of his focus to match the proportion of employee benefits spending—the real value comes through strategic customization. "Candidly, you could spend a hundred bucks, study a few hours and pass the test to be able to sell health insurance," Justin reveals. The true expertise emerges when tailoring comprehensive solutions to each company's specific cultural and economic objectives.

The episode highlights a startling workplace reality: 80% of employees worry about personal finances during work hours, losing approximately 36 hours of productivity annually per employee. With nearly half of Americans struggling with medical debt, Justin explains how innovative approaches to healthcare benefits can address these financial stressors. By functioning as a "healthcare quarterback," he helps companies provide employees with genuine choices beyond traditional healthcare pathways, where patients typically follow provider recommendations without questioning costs or comparing quality metrics.

Through real-world examples—including a nonprofit struggling to recruit tech talent despite budget limitations—Justin demonstrates how thoughtful benefits design can solve complex organizational challenges. The benefit advisor role has evolved far beyond simple insurance placement into strategic partnership that aligns employee wellbeing with company objectives.

Have questions about optimizing your company's benefits strategy? Drop them in the chat, and Justin might address them in an upcoming episode. Your organization's unique challenges deserve a customized approach that considers both economic realities and cultural goals.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Ever wonder why healthcare costs keep climbing despite supposed regulations? The answer lies in a surprising insight I gained from running a pizza business in my college dorm room.

At Cornell College, my friends and I sold $2 frozen pizzas for $5 (eventually $8) – a 75% profit margin we could maintain solely because we had no competition. This simple business lesson reveals the troubling mechanics behind our healthcare system, where major insurance companies have accumulated a staggering $371 billion in profits since 2010.

The system operates on a counterintuitive principle: while insurers face a 15% cap on underwriting profits, they make their real money by investing your premium dollars before paying claims. This creates a perverse incentive where higher healthcare costs actually benefit insurance companies. When medical expenses rise, insurers can justify collecting more premium dollars – giving them both a larger 15% profit slice and a bigger pool of money to invest.

The cold truth? Insurance companies may not mind expensive surgeries or treatments because these costs justify premium increases the following year. Every premium dollar increase means more investment capital and higher profits for them, but higher costs for you and your employees.

For businesses with 100+ employees, there's hope. You can break free from this cycle by choosing partners with incentives aligned with controlling costs while delivering quality care. Stop doing what's always been done with bad partners who profit from your rising healthcare expenses. Take control of your healthcare strategy and choose a better path forward.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Could you get the same medical procedure for less than half the price by boarding a plane? For millions of Americans facing staggering healthcare costs, medical tourism has become more than just a curiosity – it's becoming a financial necessity.

The story of 28-year-old Brianna Williams highlights this growing trend perfectly. Despite having comprehensive employer-provided health insurance, she discovered her IVF treatments would cost approximately $25,000 out-of-pocket in the United States. Her solution? Traveling to Mexico, where the same procedures cost just $7,500 – a 70% savings that made starting her family financially possible without taking on massive debt.

This isn't just happening with fertility treatments. Dental work shows some of the most dramatic differences – veneers costing $9,600 in the US are available for $2,500 in Mexico, while Europeans flock to Hungary for dental work at 75-85% savings. Even major surgeries like hip replacements ($40,000 in the US vs. $8,700 in Turkey) and gastric bypass ($23,000 in the US vs. $7,800 in Mexico) demonstrate why medical tourism is booming.

Safety remains the primary concern, which is why patients are advised to seek facilities accredited by the Joint Commission International (JCI). With over 1,000 JCI-accredited hospitals worldwide, patients can find quality care that meets international standards while saving thousands. Looking ahead, we're also seeing US doctors abandoning insurance altogether for cash-pay models, potentially creating domestic alternatives that offer similar savings without international travel. 

Have you considered medical tourism for a procedure? Share your thoughts or questions about finding affordable healthcare alternatives in today's challenging insurance landscape.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Stepping into the often overlooked yet critically important realm of employer responsibilities, today's episode tackles the concept of fiduciary duty in employee health plans. What begins as an admittedly dry-sounding legal term quickly unfolds into a fascinating exploration of how your healthcare decisions are made—and who's accountable when things go wrong.

Did you know your employer has a legal obligation to act in your best interest when selecting and managing your health benefits? The landscape of fiduciary responsibility dramatically changed with the CARES Act, which heightened consequences for employers who fail to properly oversee your healthcare dollars. I break down the four essential pillars of proper fiduciary conduct: serving participants' interests, managing plan assets responsibly, acting prudently through documented decision-making, and diligently selecting service providers.

The stakes couldn't be higher, as demonstrated by recent high-profile lawsuits where employees of corporate giants like JPMorgan Chase and Johnson & Johnson took legal action against their own employers for alleged fiduciary breaches. These cases specifically targeted how companies selected and monitored pharmacy benefit managers—an industry where just three players control over 80% of the market. I share a personal anecdote about being offered a Costa Rica trip by a pharmacy benefit manager (which I declined) to illustrate the conflicts of interest that can compromise your healthcare. Whether you're a CFO, an HR director, or an employee wondering why money keeps coming out of your paycheck each month, understanding fiduciary duty empowers you to ask better questions and demand more transparency. Ready to find out if your company is making healthcare decisions that truly serve your interests?

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

JP Morgan Chase faces a lawsuit from an employee claiming the company failed its fiduciary duty by maintaining a pharmacy benefit manager relationship that forces employees to pay inflated prices for medications. The case highlights how PBMs can create massive price disparities, with one medication costing $8,000 through the plan versus just $30 at retail pharmacies.

• Employees diagnosed with conditions requiring expensive medications are being harmed by non-transparent PBM relationships
• The medical process follows SOAP (Subjective, Objective, Assessment, Plan) but breaks down at the pharmacy level
• Price differences can be extreme - up to 200 times higher through certain PBMs
• Three major players dominate the PBM market: CVS Caremark, OptumRx, and Express Scripts
• Companies with over 100 employees should work with transparent, pass-through PBMs
• Health plan fiduciaries (typically CFOs and HR directors) are ultimately responsible for PBM selection
• Similar lawsuits have affected other major companies like Johnson & Johnson

If you're concerned about your health plan's pharmacy benefits, consult with a knowledgeable benefit advisor, such as myself, who can provide objective analysis of your current arrangements.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Shocked doesn't begin to describe our reaction when we discovered the true cost of common medical procedures. After attending an eye-opening Free Market Medical Association event in Omaha, we're pulling back the curtain on healthcare's most closely guarded secret: the massive gap between what procedures actually cost and what patients are billed.

Would you believe that your $200 comprehensive metabolic panel actually costs just $2.58 to produce? Or that the MRI you were billed $4,000 for costs independent imaging clinics only $425 to perform? The disparities don't stop there – colonoscopies priced at up to $10,000 are available through direct contracts for $1,200, while gallbladder removals costing as much as $24,000 have a true cost closer to $6,500.

The culprit behind these astronomical markups? Facilities charges that inflate prices without adding value. But there's hope on the horizon. By connecting direct primary care physicians with reasonably priced labs, imaging centers, and surgical facilities, we're creating a healthcare system that aligns incentives with patient outcomes rather than profit margins. This transparent approach is already transforming how companies and their employees access quality care without the predatory pricing that's become standard practice. Join us next time as we paint a detailed picture of what this revolutionary healthcare model looks like in practice – and how it could save you thousands while improving your care experience.

Ready to stop overpaying for healthcare? Subscribe now and discover how to navigate a system that's been deliberately designed to confuse and overcharge you. Your wallet (and your health) will thank you.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

I'm frustrated by a recent $100,000 bill my client received for a knee replacement performed at a low-quality facility. I can't help but question how we've normalized this level of waste in our healthcare system. This egregious example highlights everything wrong with healthcare today—the only industry where we blindly follow recommendations without any information about quality or cost.

But there's hope on the horizon. Progressive companies across America are creating a revolutionary healthcare experience for their employees. Picture a fork in the road: one path leads to the familiar landscape of deductibles, co-pays, and maximum out-of-pocket expenses. The other path—the one changing the game—directs employees to high-quality, reasonably-priced providers where they pay absolutely nothing for their care. Zero dollars. From routine dermatology visits to complex procedures like knee replacements, employees can access excellent care without opening their wallets.

This isn't some futuristic fantasy—it's happening now for organizations with 100+ employees. By recapturing the enormous waste in the system (like that $70,000 of unnecessary spending on a single knee replacement), employers can fund their employees' healthcare costs completely. We're eliminating waste while simultaneously improving access to quality care. If you're tired of watching healthcare costs spiral out of control, share this message with company leaders and decision-makers in your network. Together, we can transform healthcare from a burden into a benefit that truly serves people without breaking the bank.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Direct Primary Care offers quality healthcare that's accessible, personalized, and often more affordable than traditional medical practices. Justin Futrell shares insights on this alternative healthcare model and answers common questions from listeners about how it works and why it's gaining popularity.

• DPC physicians prioritize patient care over paperwork, creating flexible solutions like Justin's experience getting a throat swab between appointments
• Most DPC providers have networks of specialists who also offer reasonable cash prices for patients
• Cash pay prices can be significantly lower than insurance rates – Justin's example showed a $2,200 MRI through insurance versus $450 cash pay
• DPC providers can prescribe medications in most states, with some even providing limited pharmacy services included in membership fees
• Employers should consider embedding DPC into their health plans to improve employee benefits and potentially reduce healthcare costs

Your company should definitely be thinking about embedding direct primary care into your employer-sponsored health plan. If you liked the episode, please subscribe and give a five-star review.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.